When it comes to solving the mystery of why I recently experienced high blood sugar for a prolonged period of time, let’s just say I was a wannabe Sherlock Holmes.
I’m going with “wannabe” here because I lacked the satisfaction of deducing the exact culprit, but at least I had my wits about me enough to come up with a few reasonable explanations.
The scenario: I was riding between 200 and 250 for hours. I did a temporary increase of my insulin for a bit, took 2-3 micro-doses of insulin (in order to avoid stacking), and did my best to stay hydrated while avoiding carbs. And I barely budged, much to my frustration. All throughout dinner that night, I was anxiously eyeing my Dexcom and hoping to level out before long. It was only after I went on a 45-minute after-dinner walk that I started to drop, and it took me quite a while longer than usual for me to be totally back within range.
The questions: Did my mid-afternoon pod change throw something off? Was my carb counting wrong? Was it something I ate? Was my pod working the way it should’ve been? Did I get enough exercise throughout the day? Too much? Was it due to anxiety or stress? Some other factor that never even crossed my mind?
The clues: A couple of clues helped me eliminate the cause of the high blood sugar. For starters, it couldn’t have been the insulin – it’d been refrigerated and I’d been using the same vial for a couple of weeks without any issue. It also likely wasn’t either of my pods, because the one I’d worn for the full 3 days had worked fine, and the new one that I applied mid-afternoon did work for the full 3 days…even though it seemed to take some time to adjust to my body. I definitely didn’t eat the healthiest meal (my entree may have been a green salad, but I also ordered a sugary cocktail and had fried pickles as an appetizer). And I was dealing with slightly higher levels of stress than usual.
The case cracked (sorta): All of those aforementioned conditions combined could have contributed to the high blood sugar. Unfortunately, I can’t quite say with certainty that they did, because on paper, I did everything right in order to combat the highs. That’s just the thing with diabetes, though: You can do everything “perfectly”, and the way it “should” be done, but sometimes you can’t prevent these little mysteries from popping up and keeping life with diabetes…ah, well, “interesting”.
3 thoughts on “Diabetes Detective Work: Solving the Mystery of Prolonged High Blood Sugar”
Periods of high blood sugar remind us that we still need insulin, i call my humbling period. I have been humbled a lot lately.
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A little over a year ago I had my 1 day total insulin dispersed jump to 96 units from an average of 45 units per day for no obvious (or otherwise) reason. This condition continued for days with only slightly diminished units each day mostly due to skipping meals. My endo had no answers beyond “deal with it.” As usual I found myself having to go into research mode to find my own answers. Eventually I came to a logical determination I could be suffering from acute insulin resistance. There followed several days more of researching. Finding no acceptable short term answers I finally found a single sentence which said pooling of insulin could aggravate and even instigate insulin resistance. My Medtronic 670G insulin pump has 2 speeds of issuing insulin boluses, immediate and all within a couple of minutes…both of which logically results in insulin pooling. I began exiting Auto Mode when issuing boluses and in Manual Mode began issuing boluses in timed insulin releases using Dual Wave and Square Wave over time of 30 minutes to 24 hours. After trial & refined experimentation, depending on my actual BGs, I found that issuing all boluses over time of 30 minutes to 105 minutes resulted in returns to average daily total insulin issued of 45 to 50 units per day. There are still instances of “severe” acute insulin resistance lasting upto 2 weeks exceeding the norm, I have managed to stay with 45+ units per day.
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That is a seriously interesting set of circumstances (and some very impressive detective work on your part). Thank you for sharing!